A cognitive neuroscience perspective on psychopathy: evidence for paralimbic system dysfunction.

Abstract

Psychopathy is a complex personality disorder that includes interpersonal and affective traits such as glibness, lack of empathy, guilt or remorse, shallow affect, and irresponsibility, and behavioral characteristics such as impulsivity, poor behavioral control, and promiscuity. Much is known about the assessment of psychopathy; however, relatively little is understood about the relevant brain disturbances. The present review integrates data from studies of behavioral and cognitive changes associated with focal brain lesions or insults and results from psychophysiology, cognitive psychology and cognitive and affective neuroscience in health and psychopathy. The review illustrates that the brain regions implicated in psychopathy include the orbital frontal cortex, insula, anterior and posterior cingulate, amygdala, parahippocampal gyrus, and anterior superior temporal gyrus. The relevant functional neuroanatomy of psychopathy thus includes limbic and paralimbic structures that may be collectively termed 'the paralimbic system'. The paralimbic system dysfunction model of psychopathy is discussed as it relates to the extant literature on psychopathy.

Comparison of the late ERP negativities elicited by auditory oddball stimuli in criminal psychopaths (Kiehl et al., in press-a), patients with temporal lobe damage (Yamaguchi and Knight, 1993) and patients who had undergone temporal lobectomy for the treatment of intractable epilepsy (Johnson, 1989). All three groups are typified by an enhanced N2b, diminished frontal P3, and enlarged late negativity (N500), relative to control participants.

Illustration of the cytoarchitectural maps of Brodmann (1909, adapted from Mesulam, 2000). The components of the paralimbic system include the orbital frontal cortex, medial (amygdala and parahippocampal gyrus) and lateral (anterior superior temporal gyrus) temporal lobe, and rostral, caudal and posterior cingulate gyrus.